Intercostal catheters are used for draining fluids, either gas or liquid, from the thoracic cavity in the operating arena following intrathoracic surgical procedures for post operative drainage, in the emergency room and in various other ambulatory or health care facilities.
In most surgical procedures wherein an original incision is made, such as in the chest cavity, catheters predominantly have been inserted through an outside body opening from the inside-out. The catheter is provided with a distal end and a proximal end. The catheter is inserted through the original incision with the proximal end portion entering the incision first. A second incision or body opening is made, and a forceps is inserted through the second incision outside-in to grasp the proximal end of the catheter. The catheter thereby is pulled through the second incision until the distal end portion is properly positioned with the tube leading out through the second incision. Then the proximal end is connected to an appropriate tubular connector leading to a source of negative pressure to apply suction for draining the body cavity. Such procedures often cause ripping, tearing and coring of body tissues because of the projecting barbs formed by the forceps or the catheter or both. Our U.S. Pat. No. 3,295,527, dated Jan. 3, 1967, discloses a vastly improved intercostal catheter which not only eliminates tearing and ripping of tissue as the proximal end is drawn through a second incision by forceps, but additionally eliminates any coring effect of the tissue created by the proximal end opening of the catheter. However, with the improved catheter of the aforesaid patent, an auxiliary implement such as the forceps, must be used for positioning the catheter in an outside-in procedure.
In order to eliminate the use of forceps or like instruments, a solution was disclosed in our U.S. Pat. No. 3,459,189, dated Aug. 5, 1969, which shows a novel intercostal catheter kit including a catheter with a mating, cooperating trocar. The trocar is provided with an abutment formed near its distal end for engaging an abutment internally of the catheter tube to force the catheter through a body opening or incision by means of the trocar itself. However, here again the trocar is a separate instrument and the kit or assembly normally must be used by piercing from the outside-in.
The use of intercostal catheters often becomes a further complicated and delicate procedure when operating on patients, such as small children or infants, having very small chest cavities. It can be seen from the above that, heretofore, placing a catheter in an inside-out procedure would have been practically unheard of because a surgeon actually must operate "in the blind", using the delicate feel of his fingers for sensing placement location. The present invention now makes that possible.
The present invention is directed to providing a new and improved thoracic trocar catheter comprised of a unitary structure which completely eliminates the need for using a separate forceps or separate trocar and in which the catheter itself can be used for piercing body tissue from a body cavity in an inside-out direction.